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Module 6 > Substance USE DISORDER > Flashcards

Substance USE DISORDER Flashcards

1
Q

CNS depressants

A

Alcohol
Barbiturates
Benzodiazepines

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2
Q

Barbiturates are more easier to OD than with benzodiazepines….. why is this ?

A

Becuase it Mimic gaba that is not there

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3
Q

Benzodiazepines given for alcohol withdrawal

A

Lorazepam
Diazepam

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4
Q

CIWA score over 15

A

Pretty significant alcohol withdrawal

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5
Q

CIWA score over 20

A

Emergent and we would be in close contact with physician at this point.

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6
Q

What happens if CIWA score stays over 20 for 2 hours after giving lorazepam or diazepam?

A

We would move them to a higher level of care to prevent this

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7
Q

Alcohol withdrawal peaks

A

24-48 hours

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8
Q

Delirium tremens peak

A

2-3 days after cessation and reduction of alcohol

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9
Q

What can be given in reversal of wernicke’s encephalopathy and or even prevent this from happening

A

Thiamine and B vitamins

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10
Q

What is commonly used for alcohol withdrawal ?

A

Benzos- lorazepam

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11
Q

In regard to alcohol withdraw what can be given if benzos are not tolerated?

A

Barbiturates - phenobarbital

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12
Q

When someone is experiencing alcohol withdraw and is having anxiety and possible seizures due to the history of seizures from withdraw.. what can be given?

A

Anticonvulsant………. Gabapentin

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13
Q

What can help when a patient is experiencing autonomic symptoms such as elevated vitals, and intense sweating, during alcohol withdraw?

A

Beta blockers such as propanolol

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14
Q

What is the first in line med of choice for elevated VS during alcohol withdraw?

A

Alpha blocker… Clonidine.

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15
Q

Drugs that help with ETOH sobriety

A

Naltrexone
Acamprosate
Disulfiram
Gabapentin

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16
Q

Naltrexone

A

Reduces rewards from drinking and reduces cravings to help prevent relapse

Reduces euphoria

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17
Q

Acamprosate

A

Helps reduce symptoms of long lasting withdrawal (post acute) helps reduce insomnia , anxiety , dysphoria(negative unhappy feeling)))

Effective in pt w severe symtpoms

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18
Q

Disulfiram

A

Causes unpleasant reactions such as flushing and N&V
When a pt drinks alcohol so it makes them not want to feel the cravings or avoid alcohol

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19
Q

Gabapentin in use for ETOH sobriety

A

Helps calm down the brain so it reduces anxiety and sleep and reduce craving for alcohol

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20
Q

What can we teach the pt about disulfiram

A

To avoid any alcohol products such as hand sanitizer, vanilla, mouth wash, cooking oil.. can produce reaction

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21
Q

A pt is finishing his trial on disulfiram. What is important for the nurse to mention BEFORE he goes home

A

It may stay in his system for 14 days so avoid alcohol based things until then.

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22
Q

A pt who is experiencing severe confusion, drowsiness , lack of coordination and memory loss.. the nurse learns that the pt is experiencing overdose on benzodiazepines. What does she administer to reverse this?

A

Flumazenil

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23
Q

Opiates

A

Opium
Oxycodone
Fentanyl
Heroin
Meperidine
Morphine
Codiene
Methadone
Hydromorphone

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24
Q

Oxycodone

A

Potent and easy to OD if tolerance is not high ..
chewed, crush , snorted or inj IV

Usually what celebrates OD on if they sobered for awhile and try to take the dose they use to take.

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25
Meperidine
Potent and taken PO and still feel very high w/o IV stuff Less constipating Less urinary retention Less pupillary constriction so can’t tell when pt is high off this
26
Intoxication on opiates s/s
Constricted pupils Decrease resp sedation Decrease bp Slurred speech Psychomotor retardation
27
Toxicity triad symptoms opiates
Pin point pupils Resp depression Coma
28
Toxicity triad symptoms can lead to
Shock Seizure Cardiac arrest
29
Withdrawal opiates
Yawning(neuro) Insomnia Irritability Rhinorrhea , lacrimination Panic Diaphoresis cramps n/v/d Muscle aches Bone pain Chills/fever Increased BP & HR
30
opiate toxicity treatment emergency care
#1 airway management ..adequate o2 Candidate for intubation Medication - opioid antagonist
31
Opioid antagonist
Naloxone ( short acting) Nalmefene( long acting)
32
Naloxone
Reverse s/s opioid OD Pt may experience abrupt violent action We may want to keep multiple doses on hand till toxic level is achieved
33
Nafelmene
Long acing But can make withdrawal symptoms longer and we can expect complaint right after about withdrawal symptoms
34
Methadone
Long acting opioid ..for opioid withdrawal Can be started immediately Replacing illicit w/ a legal one We can slowly reduce dose over time
35
Clonidine is used for alcohol withdrawal but can also be used for opioid withdrawal. What does this help?
Autonomic s/s such as vitals
36
Sobriety maintence for opioids
Methadone Buprenorphine Naltrexone Suboxone
37
Methadone for opioid sobriety
Keeps away withdraw symptoms& does not have high.. so they can have a work like and family stuff .. this also helps to work on coping and life skills .. give 1x a day and administered only by opioid program
38
Buprenorphine
Can be given at med facility but authorized training course.. Reduces craving & relapse ,, mild neonatal with draw 1-3x a wk
39
Naltrexone
Blocks euphoric effect of opioids Seen a lot
40
Suboxone
Prevent high from opioids .. combo of Buprenorphine and naltrexone & helps prevent relapse
41
CNS stimulants
Cocaine , crack , amphetamines , methamphetamines
42
Short acting CNS stimulants
Cocaine Crack
43
Long acting CNS stimulants
Amphetamines Methamphetamines
44
Cocaine intotoxication
Euphoria * Dilated pupils * Elevated BP HR * N/v Insomnia Grandiosity Impaired judgement *
45
Over dose cocaine
Resp distress Ataxia Hyperpyrexia Convulsions Hemorrhagic stroke Ventricular dysrhythmias MI COMA Death
46
Withdrawal cocaine
Fatigue Lethargy sleepiness Anxiety ,agitation , insomina Disorientation Apathy Craving Depression Suicide ideation *
47
Meth intoxication short term:
dialation of pupils Increase energy Increase resp Hyperthermia Euphoria
48
Long term intoxication w meth
Paranoia w delusion s Hallucinations Anxiety Potential for violence *
49
OD in meth
Resp distress Ataxia Hyperpyrexia Convulsions Hemorrhagic stroke Ventricular dysrhythmias MI Coma Death
50
Withdrawal meth
Fatigue, lethargy, sleepiness Anxiety , agitation , insomnia Disorientation Apathy Craving Depression Suicidal ideation Hungry Symptoms can go on for months
51
CNS stimulant OD treatment
Maintain ABC Provide o2 Benzo (sedation , prevent seizure) Cooling measures Antihypertensives
52
During CNS withdrawal treatment what is given for lethargy
Modafinil
53
For CNS stim withdrawal treatment.. what is given for agitation and sleeplessness
Diphenhydramine Trazodone
54
CNS stimulant withdrawal treatment for minor pain
Analgesics
55
CNS stimulant withdrawal treatment for sedatives
Benzodiazapines
56
Club drugs
Ecstasy (MDMA) gamma hydroxybutyrate GHB Rohypnol
57
Intoxication of ecstasy
Euphoria Disinhibition Increased sensuality , empathy , closeness
58
OD on ecstasy
Hyperthermia Seizures Hypertensive crisis Cardiac dysrhythmias Serotonin syndrome Neuro :confusion ,delirium, paranoia Cognitive impairment (long term use)
59
Withdrawal ecstasy
Profound depression Confusion Sleep probs Anxiety Cravings
60
Ecstasy OD treatment
No antidote Activated charcoal Chemistry panel - kidney and liver Symptom management: ABC Cooling measures Calm quiet enviroment Sedate w benzo
61
GHB intoxication
Euphoria Disinhibition Impaired judgment Feeling drunk Amnesia Loss of control over movement Dizziness Confusion Sedation N/v Resp depression
62
OD in GHB
Cheyne strokes resp Seizures Slow breathing Low HR Low body temp Coma Death
63
Withdrawal GHB
Tremors Insomnia Anxiety
64
GHB and Rohyphnol treatment
antidote: None for GHB &&&& Flumazenil -rohypnol Activated charcoal Symptom management : ABC Cooling Calm quiet env Sedation w benzo

Module 6 (21 decks)

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